The cost of middleware (Qpath or Ultralinq) at my system is prohibitive of administration buying it. I can't be the only one in this situation (right?). I have attempted lots of arguments, but the relationships with the insurance companies & private rads groups has stopped any reimbursement arguments cold in their tracks. Funds from the residency to purchase middleware for educational purposes are non-existent.

So, I am currently performing QA "old-school". The ultrasound images are transmitted from our machine in MP4 format to a computer where I look at them. I can cut and paste screenshots into an excel spread sheet and, in that same sheet, provide typed feedback for the resident/attending as well as marked up images (arrows, text, etc). I then save the spreadsheet as a pdf file to email the provider the results of the QA. It is cumbersome, time consuming, and, most likely, why Q-path was invented in the first place.

My question for the group is: Does anyone else have this issue, and has anyone come up with a smoother less time consuming (not costly) process for providing QA feedback?